Multiple vitamins with fluoride added are used to protect against tooth decay and vitamin deficiencies in children. Fluoride has been found to be helpful in preventing cavities in the teeth.

Treatment

Crush or have your child chew the tablets before swallowing. To provide maximum protection, the multiple vitamins should be given at bedtime after the teeth have been brushed. Do not allow the child to eat for at least 15 minutes after chewing the tablets in order to allow the fluoride to work on the teeth.

The oral drops can be taken directly, or they can be mixed with juice or foods. Measure the dose carefully with the dropper provided. Do not use kitchen utensils; they are not accurate enough.

Do not give multiple vitamins with milk. Milk prevents the absorption of fluoride from the gastrointestinal tract.

If your child misses a dose of the multiple vitamins with fluoride, administer the missed dose as soon as possible. However, if it is almost time for the next dose, do not give the missed dose at all; just return to the child's regular dosing schedule. Do not double the next dose of the vitamin.

Side Effects

Minor: Occasionally, multiple vitamins with fluoride cause constipation, diarrhea, drowsiness, fatigue, loss of appetite, nausea, vomiting, or weakness. These side effects should disappear as the body adjusts to the vitamins.

To relieve constipation, increase the amount of fiber in your child's diet (with fresh fruits and vegetables, salads, bran, and whole-grain breads) and encourage your child to drink more water (unless your child's doctor directs you to do otherwise).

Major: Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about bloody or black, tarry stools; difficulty in swallowing; discoloration of the teeth; excessive drooling; excitation; mouth sores; rash; stomach cramps; or tremors.

Interactions

Multiple vitamins with fluoride should not interact with other medications if it is used according to directions. But be sure that your child's doctor knows about any medications that

your child currently takes.

Warnings

Tell your doctor about any unusual or allergic reactions your child has had to vitamins, fluoride, or any other medications or supplements.

Be sure to tell your doctor if your child now has or ever had one or more of the following: bone, heart, kidney, or thyroid disease.

If the fluoride content of your drinking water is 0.7 parts per million or more, do not use the chewable tablets. Do not give the oral drops to children younger than three years of age in areas where the drinking water contains 0.3 parts per million or more of fluoride. If you are not sure of the fluoride content of your drinking water, ask your doctor or call the county health department.

Vitamins with fluoride are often prescribed for infants who are not being given any source of fluoridated water. Once your infant is given fluorinated water consistently, ask your doctor if you should still continue to give this medication to your child.

Never call this medication "candy" or "candy-flavored vitamins." Your child may take you literally and attempt to eat them like candy, swallowing too many of them. An overdosage of vitamins can have dangerous consequences and requires immediate medical attention. Call your local poison control center or emergency services.

Storage: Store the regular and chewable tablets at room temperature in a tightly closed, light-resistant container. Store the oral drops at room temperature in the original plastic container (glass containers interact with and destroy the fluoride in the solution). A slight darkening in the color of the drops does not indicate a loss in potency of the vitamins or fluoride; the solution can still be used safely. Do not refrigerate or freeze any form of these vitamins.